MFN Money.

While radiation oncology has the RO Model looming in 2021, you may have heard rumblings amongst medical oncology about the Most Favored Nation (MFN) model. A common criticism of CMS spending is that they, historically, haven’t been able to negotiate drug prices. The MFN Model is a mandatory nationwide model that seeks to lower the price paid by CMS for drugs covered under Medicare Part B. More specifically, it focuses on 50 drugs that represent a large share of CMS drug spending. As you can imagine, this includes quite a few cancer therapies. Instead of using the manufacturer’s “average sales price,” CMS will calculate a MFN price based largely on the lowest international price paid by countries with a per capita GDP that’s at least 60% of the U.S. It’s a 7 year model, and price reductions phase in over the first 4 years. TBL: The mandatory, nationwide MFN Model could radically change how CMS pays for many cancer therapeutics. | CMS 2020